Acid–base, electrolyte and metabolite concentrations in packed red blood cells for major transfusion in infants

Abstract

Massive and rapid transfusion of RBC may lead to a severe burden of hydrogen ions, carbon dioxide, potassium, glucose and lactic acid and this can be avoided by cell saver blood processing, when autologous erythrocytes from the operative field are saved and substrate load and storage lesions from packed red blood cells are minimized in one step by washing.

Duration of storage influences the hemoglobin rising effect of red blood cells in patients undergoing major abdominal surgery

“…Our results confirm that transfusion of FFP is associated with increases in serum c Na, whereas transfusion of senescent RBCs is associated with minor decreases and not increases of c Na. Our findings are supported by available data on sodium content of RBCs showing that c Na in the supernatant declines during storage, resulting in c Na below physiological ranges after 14 days . Previous assumptions might have been due to the study design disregarding confounders such as FFP and sodium bicarbonate administered in parallel and the relationship of c Na changes with RBC transfusion during different periods during surgery .…”

Effects of red blood cell transfusions during the first week of life on acid‐base, glucose, and electrolytes in preterm neonates

“…This might be due to minor differences in the age of RBC units, procedures used to concentrate the blood, and duration of time from concentration and irradiation 7 occurring despite all the efforts made to standardize the procedure of RBC unit preparation. However, a high variability of K + concentration in RBC units has been previously described: Thorp and colleagues 14 reported in their study a K + concentration of 66.5, 65.3, and 58 mmol per L in 3 of 8 RBC units (range 13.9‐66.5, mean 44.7 mmol/L); Batton and colleagues 25 reported a K + concentration in RBC units ranging from 6.5 to 32.5 mmol per L; and Sumpelmann and colleagues 16 reported a K + concentration in RBC units of 20.5 ± 7.8 mmol per L (range 4.2‐43.6 mmol/L).…”

The strong ion gap predicts mortality in children following cardiopulmonary bypass surgery*

“…In contrast, red cell primes, which are used almost universally in pediatric cardiac surgery, provide an abundant source of lactate, which increases with the age of the blood (7). There is a strong correlation between lactate levels in the red cell prime solution and initial postoperative blood lactate concentration (19). This factor may partly explain the lack of a consistent predictive value for admission lactate in this setting (4).…”